Professional Documents
Culture Documents
Liabilities of Hospitals
Liabilities of Hospitals
Transcribed by: KC
A.
1. Not in the interest of public safety, health and welfare and therefore
contrary to public policy. (hospital for profit)
1. State Regulation for the interest of public health, safety and welfare
2. Self Regulation internal rules and regulations
Primary duties of a hospital
1. General Hospital
2. Specialized Hospital
B.Functional Classification:
1. Diagnostic hospital
2. Maternity Hospital
3. Rehabilitation Hospital
4. Surgical Hospital
5. Cosmetic Hospital
C. Control and Financial Support
1. Public or Government Hospital
2. Private Hospital
a. Private charitable or eleemosynary hospital
b. Private pay hospital
D.
Size or Bed Capacity
E. Training or not
Hospital cannot practice medicine
Practice of medicine
Diagnosis and application and the use of medicine and drugs for
curing, mitigating or relieving bodily disease or conditions (People v.
Mattie, 381 Ill., 21, 44 NE (2d) 756 1942).
Acts Constituting Practice of Medicine
Any person shall be considered as engaged in the practice of medicine
a. who shall, for compensation, fee salary or reward in any form paid to
c. who shall falsely use the title of M.D. after his name.
of the
hospital staff
intentional injury
3. Invitee should provide safe condition and must give warning for any
danger.
Liabilities of Hospitals for the wrongful acts of their agents or employees
1. Corporate liabilities
a. failure to furnish safe and well maintained buildings and grounds;
b. Failure to furnish safe and reliable equipments;
c. Failure to make careful selections, review and supervision of
independent physicians
2. Vicarious liabilities
a. Nursing staff
1. Student Nurse
2. Professional Nurse
3. Special Duty Nurse
b. Medical Staff
1. Interns
2. Resident Physicians
3. Consultants
ADMISSION
Emergency Cases
when the patient is mentally ill such that his release will endanger
public safety
patient for the unpaid obligation. In the case of a deceased patient, the
corresponding death certificate and other documents required for
interment and other purposes shall be released to any of his surviving
relatives requesting for the same: Provided, however, that patients who
stayed in private rooms shall not be covered by this Act.
a) The
b)
d)
pay the
corresponding hospital bills or medical expenses/hospitalization
expenses;
d)
RAMOS et. al., vs. COURT OF APPEALS (G.R. No. 124354 December 29,
1999)
In the first place, hospitals exercise significant control in the hiring and firing
of consultants and in the conduct of their work within the hospital premises.
Doctors who apply for "consultant" slots, visiting or attending, are required to
submit proof of completion of residency, their educational qualifications;
generally, evidence of accreditation by the appropriate board (diplomate),
evidence of fellowship in most cases, and references. These requirements are
carefully scrutinized by members of the hospital administration or by a
review committee set up by the hospital who either accept or reject the
application. 75 This is particularly true with respondent hospital.
After a physician is accepted, either as a visiting or attending consultant, he is
normally required to attend clinico-pathological conferences, conduct
bedside rounds for clerks, interns and residents, moderate grand rounds and
patient audits and perform other tasks and responsibilities, for the privilege
of being able to maintain a clinic in the hospital, and/or for the privilege of
admitting patients into the hospital. In addition to these, the physician's
performance as a specialist is generally evaluated by a peer review
committee on the basis of mortality and morbidity statistics, and feedback
from patients, nurses, interns and residents. A consultant remiss in his duties,
or a consultant who regularly falls short of the minimum standards
acceptable to the hospital or its peer review committee, is normally politely
terminated.
In other words, private hospitals hire fire and exercise real control over their
attending and visiting "consultant" staff. While "consultants" are not,
technically employees, a point which respondent hospital asserts in denying
all responsibility for the patient's condition, the control exercised, the hiring,
and the right to terminate consultants all fulfills the important hallmarks of
an employer-employee relationship, with the exception of the payment of
wages. In assessing whether such a relationship in fact exists, the control test
is determining.
RAMOS et. al vs. COURT OF APPEALS, [G.R. No. 124354. April 11, 2002]
DLSMC maintains that first, a hospital does not hire or engage the services of
a consultant, but rather, accredits the latter and grants him or her the
privilege of maintaining a clinic and/or admitting patients in the hospital
upon a showing by the consultant that he or she possesses the necessary
qualifications, such as accreditation by the appropriate board (diplomate),
evidence of fellowship and references. Second, it is not the hospital but the
patient who pays the consultants fee for services rendered by the latter.
Third, a hospital does not dismiss a consultant; instead, the latter may lose
his or her accreditation or privileges granted by the hospital. Lastly, DLSMC
argues that when a doctor refers a patient for admission in a hospital, it is the
doctor who prescribes the treatment to be given to said patient. The
hospitals obligation is limited to providing the patient with the preferred
room accommodation, the nutritional diet and medications prescribed by the
doctor, the equipment and facilities necessary for the treatment of the
patient, as well as the services of the hospital staff who perform the
ministerial tasks of ensuring that the doctors orders are carried out strictly.
As explained by respondent hospital, that the admission of a physician to
membership in DLSMCs medical staff as active or visiting consultant is first
decided upon by the Credentials Committee thereof, which is composed of
the heads of the various specialty departments such as the Department of
Obstetrics and Gynecology, Pediatrics, Surgery with the department head of
the particular specialty applied for as chairman. The Credentials Committee
then recommends to DLSMC's Medical Director or Hospital Administrator the
acceptance or rejection of the applicant physician, and said director or
administrator validates the committee's recommendation. Similarly, in cases
where a disciplinary action is lodged against a consultant, the same is
initiated by the department to whom the consultant concerned belongs and
filed with the Ethics Committee consisting of the department specialty heads.
The medical director/hospital administrator merely acts as ex-officio member
of said committee.
Neither is there any showing that it is DLSMC which pays any of its
consultants for medical services rendered by the latter to their respective
patients. Moreover, the contract between the consultant in respondent
hospital and his patient is separate and distinct from the contract between
respondent hospital and said patient. The first has for its object the rendition
of medical services by the consultant to the patient, while the second
concerns the provision by the hospital of facilities and services by its staff
such as nurses and laboratory personnel necessary for the proper treatment
of the patient.
Further, no evidence was adduced to show that the injury suffered by
petitioner Erlinda was due to a failure on the part of respondent DLSMC to
provide for hospital facilities and staff necessary for her treatment.
Nogales vs. CMC [G.R. No. 142625] December 19, 2006
After a thorough examination of the voluminous records of this case, the
Court finds no single evidence pointing to CMCs exercise of control over Dr.
Estradas treatment and management of Corazons condition. It is undisputed
that throughout Corazons pregnancy, she was under the exclusive prenatal
care of Dr. Estrada. At the time of Corazons admission at CMC and during her
delivery, it was Dr. Estrada, assisted by Dr. Villaflor, who attended to Corazon.
There was no showing that CMC had a part in diagnosing Corazons condition.
While Dr. Estrada enjoyed staff privileges at CMC, such fact alone did not
make him an employee of CMC. CMC merely allowed Dr. Estrada to use its
facilities when Corazon was about to give birth, which CMC considered an
emergency. Considering these circumstances, Dr. Estrada is not an employee
of CMC, but an independent contractor.
The question now is whether CMC is automatically exempt from liability
considering that Dr. Estrada is an independent contractor-physician.
In general, a hospital is not liable for the negligence of an independent
contractor-physician. There is, however, an exception to this principle. The
hospital may be liable if the physician is the ostensible agent of the
I.
EMERGENCY ROOM
1. Independent contractor
2. Employees
*In the absence of clear indication to the contrary, the public has a right to
rely on the common assumption that emergency ward personnel work for
and in behalf of the hospital (Badeux v. East Jefferson Gen. Hospital 364 So.
2d 348 La Xt. App. 1978)
Two Aspects of Emergency Care:
a. Examination
b. Performance
1. Failure to admit
2. Failure to examine and/or treat
3. Negligence in the Application of Management Procedures
a. Basis
b. Documentary
MD.
A.
B.Hospital Record:
1. Identification Information
2. Evidence of appropriate informed
fracture of forearm.
4. Short and long back boards with 2 inch webbing straps for extrication of
victims with spine injuries.
nurses notes
size masks
padded.
11.
12.
13.
14.
15.
16.
17.
Personnel
III.
Hospital Pharmacy
vicarious liability
IV.
Medical Records
Purpose:
1. History
2. Physical findings
3. Diagnosis
4. Course of treatment
5. Course of the disease
associated
HOSPITAL
PHYSICIANS REACTION TO THE PROBLEM OF MALPRACTICE
Praestet cautela quam medala
Out of 467 cases filed, 220 (47%) are with gross negligence/
malpractice.
OB-Gynecology
Surgery
anesthesiology
pediatrics
=
=
=
(30%)
=
(15%)
(40%)
(20%)
others
(5%)
consulting to confirm dx
overtreatment
qualitative
quantitative
1. Financial losses
2. Physical and emotional harm
3. Side effects
4. Bad impression by the patient on previous M.D.
House Bill No. 4955
Introduced by REPRESENTATIVE OSCAR S. RODRIGUEZ
EXPLANATORY NOTE
3. That
Dr. Romeo Encanto, one of the speakers in 98th PMA Convention in Bacolod
City:
If you are accused of malpractice and you have the possibility of prision
mayor, then just admit that you really intended to kill the patient. There, you
will have a lesser penalty Thats how preposterous the bill is.
Art. 365. Imprudence and Negligence. Any person who, by reckless
imprudence, shall commit any act which, had it been intentional, would
constitute grave felony, shall suffer the penalty of arresto mayor in its
maximum period to priccion correccional in its medium period
4 months and 1 day to 4 years and 2 months.
September 29, 2002, Alliance of Health Professional Organization (AHPO),
composed of various health organizations including PMA, assembled and
staged massive protest in Cuneta Astrodome denouncing the medical
malpractice bill and called it a direct attack against the medical community
The penalty imposed by the proposed bill, i.e. prision mayor and fine of
P500,000 to P1,000,000 is very harsh and very severeit does not distinguish
between a doctor and an ordinary criminal. Under the bill there seems to be
no difference between someone intentionally putting a bullet between the
eyes of his victim and a doctor or a nurse accidentally puncturing a patients
skin in the course of giving a shot of medicine in a patients arm.
Former Supreme Court Justice Isagani A. Cruz expressed dismay about the
proposed excessive monetary penalty. He wrote in his Philippine Daily
Inquirer column:
Section 20 of the Bill of Rights clearly and expressly provides that
excessive fines shall not be imposed.
Moreover, the due process clause requires an equivalence between the
offense and the penalty, unlike under the bill in question, where the
fine can be as high as a million pesos. It is like punishing jaywalking with
life imprisonment.
Senator Sergio R. Osmena III pushed his controversial Senate Bill 1720 or
Anti-Medical Malpractice Act of 2004
Incidents of malpractice and negligence involving medical and dental
practitioners are on the riseSadly, such negligent acts of unscrupulous
medical and/or dental practitioners have sometimes resulted in temporary or
permanent disability of death.
In January 2003, the University of the Philippines Manila, Health Sciences
Center of the U.P. System, headed by Chancellor Marita V.T. Reyes made a
consolidated position paper objecting the bill intention to punish medical
malpractice as a tool to enhance the quality of health care.
1. The bill will increase the already high cost of health care (defensive
medicine),